腹腔镜胆囊切除手术入路的研究

Surgical approaches for laparoscopic cholecystectomy

目的:探讨3种腹腔镜胆囊切除(LC)手术入路的适用范围。方法:回顾性分析2009年1月—12月经腹腔镜胆囊切除术治疗150例胆囊良性疾病行LC的临床资料。结果:150例腹腔镜胆囊切除术中三孔法46例,二孔法54例,经脐入路50例,3组患者的手术成功率、手术时间、术中岀血、术后肠功能恢复情况无差异(均P>0.05);在术后疼痛、术后住院天数方面,经脐入路组明显优于其他两组(均P<0.05)。3组患者出院后随访均无腹痛、黄疸、胆瘘、岀血、腹壁切口疝等并发症。结论:3种手术入路均能安全完成腹腔镜胆囊切除术,不同患者应根据实际情况选用不同入路,以手术安全为选择标准。

Objective： To determine the applicable scope of three types of surgical approach for laparoscopic cholecystectomy. Methods： The clinical data of 1SO patients with benign gallbladder diseases undergoing laparoscopic cholecystectomy （LC） from January to December 2009 were retrospectively analyzed. Results： Of the 150 patients, laparoscopic cholecystectomy was performed via three-port approach in 46 cases, two-port approach in 54 cases, and transumbilical single-port approach in 50 cases. There were no differences among the three groups in the operation successful rate, duration of operation, intraoperative blood loss, andtime for intestinal function recovery （all p〉0.05）, The transumbilical approach was better than the other two approaches in regards to postoperative pain and length of hospital stay （all p〈0.05）. No complications such as abdominal pain, iaundice, bile leakages, hemorrhage or incisional hernia occurred in any of the patients of thethree groups during the follow-up period. Conclusion： Any of the three types of surgical approach can be used for the safe performance of laparoscopic cholecystectomy. However, the selection of the approach should be based on the patient＇s individual conditionand the principle of surgical safety.